Electronic medication management service for residential care homes for the elderly in Hong Kong: a pre-post interventional study

Background: In Hong Kong, medication management in residential care homes for the elderly (RCHE) is typically handled manually, which is time-consuming and labourintensive. In 2021, the Hong Kong Pharmaceutical Care Foundation developed and implemented an integrated medication management system to a network of RCHEs. This system features a comprehensive database with drug images and common dosages to build electronic medication profiles and electronic medication administration records for residents. This study evaluated the effect of this system on improving time efficiency and technical competency of RCHE staff, and to estimate the drug wastage costs that could potentially be circumvented when the centralised automated packaging service is implemented. Methods: This was a pre-post interventional study. Time efficiency was evaluated using time motion analysis. The number of doses prepared, checked, and administered in 10-minute blocks before and after implementation was compared using analysis of variance. The RCHE staff completed a structured survey to report their technical competencies in various aspects of medication management. The quantity and cost of wasted medications were quantified from drug disposal reports. Results: In total, records of 1218 residents (mean age, 85.8±8.7 years; median medications per resident, 11) in 14 RCHEs were analysed. The system improved time efficiency, as reflected by a significant increase in the number of doses prepared (14.0±3.1 vs 44.7±7.9), checked (18.8±9.6 vs 119.8±22.6), and administered (12±3.2 vs 41±1.9) in 10-minute blocks (all p